Tanya Hale 00:00 

Hey there, welcome to Intentional Living with Tanya Hale. This is episode number 355, "Understanding Menopause with Dr. Taylor Hahn." Welcome to your place for finding greater happiness through intentional growth, because we don't just fall into the life of our dreams;;;we choose to create it. This is Tanya Hale, and I'm your host for Intentional Living. 

Tanya Hale 00:23 

Alright, hello there, my friends. Welcome to the podcast today. Got something great for you, but before we jump into the content, I wanted to let you know our next Talk with Tanya is going to be May 13th. That is at 2 p.m. Eastern, 12 o'clock Mountain, a second Tuesday of every month. And you just need to go to my website, tanyahale.com. You can go to the "group coaching" tab, and there is a place there for you to sign up. You'll get an email with the Zoom link. They've been great, such an amazing opportunity to answer questions, get some coaching done, dive deeper into concepts. So make sure you join us there if you want. 

Tanya Hale 01:04 

And also just a quick reminder, if you are interested in more podcasts that have to do with the content that we talk about on the show, I want you to go down to the show notes, wherever you listen to your podcast, and there will be a list of podcasts that I have done that cover similar topics. So that being said, today I am sharing with you a discussion that I had with Dr. Taylor Hahn. She is an OBGYN here in Indiana, and she is a menopause specialist. So as I have learned over the last few years, not every OBGYN knows all the things about menopause. And this has been something that Dr. Taylor Hahn has specialized in, in learning and understanding and making this one of the things that she really has trained herself to know about better. And she has information at the end about where you can find a menopause specialist in your area. 

Tanya Hale 02:08 

So I love this conversation about hormone replacement therapy, and just so many of the things having to do with menopause. And I think you're gonna like it too. She was just a delightful, delightful person. And I'm gonna have her on again, where we're going to answer some questions about menopause. So if you have questions that you would like to ask, I would love for you to send them to me. So look for a link in my "weekend win" letters, or you can go to my website and go to the "contact me" tab and just send me a quick email with questions you have about that. And we will have her on in the next couple of months. Okay, Taylor, Dr. Hahn, I guess maybe I should call her. 

Taylor Hahn 02:53 

Taylor is totally fine. 

Tanya Hale 02:55 

Glad to have you here today. Will you start off by introducing yourself to all the peoples out there? 

Taylor Hahn 03:02 

Yes, absolutely. So I'm Dr. Taylor Hahn. I am a board certified OBGYN and I'm also a certified menopause practitioner through the Menopause Society. 

Tanya Hale 03:14 

K, I would like to know like how you got into menopause. Because if I understand correctly from what we've talked about, and knowing that my husband's an OBGYN, he's not a menopause specialist. So how did you, how did you narrow down into that, into that arena? 

Taylor Hahn 03:30 

So I have always had a love for the, I call it the gynecologic portion. You know, if we split our specialty into two, there's the obstetric portion and the gynecologic portion. I've always had a passion for gynecology, seeing patients at a time where they feel very vulnerable. There's a lot of medical issues going on that can affect throughout their daily lives. And it's not just, you know, the joys and excitement of related to pregnancy. And so I've always had a love for that part of the practice,  but when you get out of residency training, I think a lot of us go into wanting to do it all and really wanting to try to provide great care for all aspects of women's life, which can be done, but difficult sometimes when you're trying to balance taking care of emergencies for women and their pregnancies, and then trying to see women in the office who have concerns about gynecology or menopause, sexual health as well. And so I really found that I was doing my patients a disservice by not understanding and not educating myself a little bit more on those topics. And so that sort of led me down that road of trying to get more education and just making sure that I could be the best doctor for my patients. 

Tanya Hale 05:04 

Mm hmm. I love that. So menopause, like this is the middle age women's like monstrosity that we all, and monstrosity is probably strong, right? It can be an amazing thing. 

Taylor Hahn 05:15 

No, it can be a monster. 

Tanya Hale 05:18 

We're always like, so glad that our periods are done. But we're all just also just like, what is this going on in my body? What's happening? So will you talk a little bit about the menopause process? Like what happens in our bodies, and why it happens and how it manifests itself and why it can be such a challenging time for women. 

Taylor Hahn 05:38 

Yes, absolutely. I always think about it as it's just kind of unfair, right? You're finally getting to a point where you're not having to worry about periods regularly and you're not having to maybe worry about possible pregnancy as well. But then you have this whole other world of symptoms that nobody ever talks about to you. You maybe have not even had a conversation with family or friends, let alone your doctor. And so lots of changes that can occur head to toe. 

Taylor Hahn 06:15 

So menopause, in general, is the process as we age where it's sort of just ovarian aging, right? So it's typically about the ovaries and how the hormone production of the ovaries starts to wax and wane. We call that going into perimenopause. So that time frame that sort of is leading up to the menopause transition. And menopause, for those out there looking for kind of a solid definition, is when you have been 12 months without a period. But for a lot of patients, they're having symptoms for years before that that we sort of just deal with and accept and think, "oh, this is maybe it'll go away tomorrow." And then those tomorrows turn into multiple years. And you're sort of just sitting in misery and discomfort for years when we could be doing something about it for you. 

Tanya Hale 07:21 

So can I ask why does it sometimes stretch out so long? Like I've talked to women who have said like they've had hot flashes for 15 years straight and not just like an occasional mild "woo, I'm getting a little bit warm" but like dead on sweating for 15 years. Like what causes our bodies, some people's bodies to stretch that out for so long? Why is it, why can't it be such a arduous process that way? 

Taylor Hahn 07:44 

Yeah, it really has so much to do with that decreasing level of hormone production. So we're talking estrogen, progesterone, testosterone, all of those components. We call them the sex hormones, but really they're not just about sex, right? They're going everywhere in our bodies and they have effects everywhere as well. So we know that as that decreases, it's never going to come back. Eventually you're going to get to a point where that ovarian hormone production is basically zero. And that can lead to all of those effects. We talked about the hot flashes and that drenching sweat, that's primarily temperature, we call it dysregulation, or just that severe fluctuation that causes some of those symptoms to just pop out and they'll pop out at random, which is the not fun part because you could be in the middle of the grocery store and break out in sweat. So I think it really has a lot to do with just the consistent decline of hormone production. 

Tanya Hale 08:57 

What are some of the other major symptoms or maybe even some of the lesser known symptoms that come up with menopause that might shock people that that's menopause related? 

Taylor Hahn 09:08 

Yeah, absolutely. Besides kind of the typical hot flashes, night sweats that we hear a lot about, I have conversations constantly about sleep, not being able to get to sleep, not staying asleep, multiple nighttime awakenings, and that may be  hot flash or night sweat related as well, but it may just be a baseline how your sleep habits change. Weight gain is a huge component of the conversations that I have, and not just the weight gain portion, but also not being able to lose weight. We put on a lot more visceral fat, meaning fat around the organs and the belly, instead of that, I call it the pension inch fat, where it used to be when you were 25, if you gained a few pounds because you ate poorly or maybe had a weekend out, you could lose that pretty quickly, and that is not the case when that changes in menopause. Hair loss, changes in your skin, dryness, that includes everywhere, so I talk to patients a lot about gynecologic and actual vulvar and vaginal care because that is skin, that is tissue, that also responds to bones. People a lot of times don't think about that because they think, "oh, I had my pap smear done and that is all I need," but there are so many changes that happen in that area as well. Joint pain, we have bone density loss when we think about obviously wanting to prevent osteoporosis, and then also muscle loss. That is actually one of the bigger ones that I like to talk to patients about because we are usually not nearly as active and we are also not doing as much to actually build and maintain muscle as we age as well. 

Tanya Hale 11:14 

Wow. So it's just, there's a lot of just overall physical health decline. And then with the change in those, um, hormones, what about the emotional health and how it impacts emotionally and mentally even, right? Like how does that work? 

Taylor Hahn 11:29 

Absolutely. I have patients who they have newly developed anxiety, depression. We talk about mood swings, but I think that really puts it lightly. It can be devastating, it can affect your daily life, it can affect your relationships. It can be really significant to have those experiences and very scary because you don't feel like yourself. A lot of times patients can't necessarily pinpoint exactly what is happening, but they'll come to me just in tears and say, "this is not me, this is not who I am." And so trying to navigate that can be really challenging. 

Tanya Hale 12:20 

Yeah. And libido. Let's talk about the impact that it has on our libido as well. 

Taylor Hahn 12:27 

Could be one of the biggest ones. I think it's tough because we're still, I think in a society that where we're talking about sex, even with your provider, is still just very taboo and very hush-hush. And on the flip side, I think providers and physicians don't, we're not always comfortable talking about sex in general or just saying the word. And so trying to navigate where you were and then where you are in terms of desire, responsiveness to intimacy, where your relationship is now. We've talked a little bit, Tanya, about just how you get to this point, but you're in a very different part of your life where you might have kids going away. You might have parents who are sick that you also then have to go still be in the position of caretaker. But then you're also trying to navigate a relationship with a partner in times where your body, you feel wholly unlike yourself. And so putting all of those things together is just, it can be really overwhelming. 

Tanya Hale 13:51 

It's like a perfect storm, isn't it? Like this middle age piece, because we have all of these life changes happening. Kids leaving home, trying to reconnect with a spouse. You know, if you've been in a long-term relationship, a lot of divorces happen in middle age, more and more actually, and more and more initiated by women. As you said, you know, parents getting older, like so many life changes going on. And then it's like, yes, this is layer on all of this emotional stuff. And so our ability to emotionally regulate and to mentally, even the mental clarity of mind that we want to have sometimes seems to be affected by menopause as well. Then all the physical changes that can create distress, the lack of libido that can impact our relationship. All of that impacts our relationship as well. But so here we end up with this perfect storm. Like middle age, perfect storm. 

Tanya Hale 14:49 

So hormone replacement therapy is something that has become really a big thing. It didn't exist, I think, for thousands of years. And women just had to go, okay, like here I am, next phase of what feels like a crazy body, right? So how does hormone replacement therapy work? And when is it a good option? 

Taylor Hahn 15:12 

Yeah. So I think it's important, just the nerd in me wants to make sure that patients understand that hormone therapy, it has sort of had waves of popularity, I'll say. Back in the 80s to 90s, it was becoming more popular and it was becoming more mainstream. And then that is when the big study called the Women's Health Initiative came out in the early 2000s. That really was devastating for women's health in general, but primarily menopause and hormone replacement therapy. It  basically came out and said, "if you take hormone replacement therapy, you are going to get breast cancer." 

Tanya Hale 16:03 

I remember that because I had had a hysterectomy before that or right about that time and I was going a little bit like this whole thing I said, like this is not me. Like I was explosive, which is not my personality. I had this huge weight gain, which also was never anything that my body had ever had fluctuations. So I remember going to that and my doctor saying, well, "you know, like breast cancer is a big deal with this." And I remember thinking, "well, I would rather die 10 years earlier than treat everybody the way that I'm treating them right now because I would rather die with people liking me, with people hating me," right? 

Taylor Hahn 16:42 

Not even just the liking you, but just like being able to be in harmony and have that strength of relationship. A lot of times that becomes almost an impossibility whenever your hormones are fluctuating so wildly. So yeah, so that study came out. It really was so devastating and has really been detrimental across the remaining decades up until present time. 

Tanya Hale 17:11 

Have there been others that have come out that have shown something different or not? 

Taylor Hahn 17:15 

So there are currently studies that are ongoing, that are looking at the long-term effects of hormone therapy. There will probably never be another study like the Women's Health Initiative because it was an actual randomized controlled trial. And so to do that on such a large scale, while it takes funding for women's health, which I don't know that we'll ever see at that scale, but it also, we know now that some of the results in the Women's Health Initiative were incorrectly interpreted. 

Tanya Hale 17:53 

Okay. 

Taylor Hahn 17:53 

Um, and so I still see patients who still have that mentality. Um, and there are even patients who are, who are kind of well, um, outside of where the women's health initiative really would have come out, you know, um, any reading that they would have done, they would have had to do, you know, going back into more like historically, um, historical books, right? Um, but there's still that fear mentality that patients come in with and they say, "well, isn't this going to cause me breast cancer? or, or isn't this going to increase my risk for, um, heart attacks and strokes and all of that." So, um, it's really a big conversation that I have. But I think hormone replacement therapy, and then another term that we sort of use for it is menopause hormone therapy or MHT. Um, so either way on those, I think that there's a really great way to balance the risks versus in giving you the benefits of hormone therapy. Um, and a lot of that comes with working with your provider or working with someone consistently, um, to make sure that this is, uh, the right fit for you and the right, um, treatment regimen. 

Tanya Hale 19:13 

Okay, so it's not just like, let me go to the store and buy stuff off the counter, or off of the shelves, right? Because yes, to be more monitored to make sure that we're we have that good balance. 

Taylor Hahn 19:26 

Yes. I mean, how many of us have gone to the store and bought however many over the counter supplements, creams that have promised us youth and relief and gotten either minimal results or no results, right? There is really nothing that is probably going to be a better gold standard than hormone therapy when it comes to treating menopause symptoms. And so that's kind of the conversation and mentality change that I try to talk with patients about because a lot of patients think, well, let me just take 12 supplements instead, because that's more "natural" than taking hormone therapy. And I kind of try to reiterate, like your hormones, you have hormones. So really hormones is the most natural. While it's a medication that we prescribe and that we monitor for you, it's so much safer and more natural than taking supplements maybe that are not regulated and that we don't have great evidence for that. It really gives you the benefit that hormone therapy does. 

Tanya Hale 20:48 

Okay, so if managed well, if I understand you correctly, you're saying that the risks of breast cancer and heart disease and all these other things you talked about really can be minimized with a good hormone replacement with a well-managed... 

Taylor Hahn 21:08 

Yes, absolutely. You know, there's a lot of talk about various forms of hormone therapy out there and what is the safest and what is not the safest. And, you know, in my practice, I really try to stick with FDA-approved versions of hormone therapy. I know that's not how everyone practices and I know that's not how every patient, you know, the kind of care that every patient wants. But we know that those are well-regulated. They're actually quality controlled and tested for safety. And so I really, it's trying to balance giving patients relief with also keeping them safe. 

Tanya Hale 21:55 

OK, so that kind of leads me to my next question. So menopause is just a natural part of what our bodies are going to do as we age. And yet we also receive all of this societal belief that, "listen, you should still look like you're 23. Like, here's the stuff for your skin. Here's the stuff for your... Here's how you should work out and what you should do to your hair." Like this whole thing, like we should be eternally young, and yet this is a part of our natural body process. And so how do we balance out this this I'm feeling horrible and I don't feel like myself and my libido has tamed and it's impacting my relationships with also this is just part of what happens to me as a 57 year old woman, like I'm in a space in my life that that this is where my body is because it's what it's my body is supposed to do. So how do we balance all that out in our brains? 

Taylor Hahn 22:55 

Very carefully and, and I would say very thoughtfully. When a patient comes to see me, it is not, I don't make promises to them of this is how I want you to feel. This is the, we don't shoot for, um, I want you to look and feel like you're 22, right? Um, it is, you still have to take into consideration that all of the body changes are there. They are beautiful. They're natural. There are things that are happening that, um, that mean that you have lived life, lived years on this earth and, and also have the wisdom to, to be able to still be alive, which is amazing. But it's more so trying to transition to a point where you can still feel like yourself. Um, but, uh, but really the goal is not, um, you know, I say this to my patients a lot. My goal is not to get you skinny. Uh, it's not to, you know, get your skinny, sexy young. Um, it's more so thinking about your strengths, your long-term health, decreasing, you know, cardiovascular disease or heart disease. Um, and, and those risks that come with age primarily, um, and then getting you to a point where I want you to be able to, to sit down on the floor and get up, you know, without issues, um, and not have to worry about falling and, uh, and things like that. So it's really more for me about strength and movement and, um, and that clarity of mind and, and helping with that portion. 

Tanya Hale 24:36 

Okay, so kind of this balance, like, yeah, because I just always think, like, my brain works in the way that I think, well, this is what my body's supposed to do. And yet, but then I use it in the context of, well, my body was also supposed to give birth to a baby. But does that mean that I don't want an epidural? Or my body is going to lose a tooth once in a while. But does that mean that I don't want you when I need that root canal? Does that mean that I don't want pain meds for that, right? Like, I think that there are things that are a blessing to the pain that we can experience and the discomfort we can experience in this day and age because of the progress that we've made. But at what level does it become? 

Taylor Hahn 25:20 

I think it's more for me about focusing on what can we do to help with your longevity of life and not necessarily just to make you feel good, right? We're going to have aches and pains throughout our life. We're going to have injuries. We're going to experience changes where we say, ooh, that's not how I felt when I was 20 when I did that, you know? I have this conversation a lot with my husband because he likes to play soccer regularly and I have to remind him. I'm like, you know, just be safe, be careful, you know? Like you're not 20 anymore playing soccer. So, but I think it has more to do with the longevity of life portion and your overall health than, and that is where I focus on the benefits of hormone therapy rather than I want to make you, your skin glow and I want to make your body look amazing. It's not as much about how you look physically as opposed to pairing your physical body health with your overall feeling of how you feel about yourself. 

Tanya Hale 26:43 

Okay, love that. Okay, so what would you suggest would be some of the best questions for someone to take to their provider and how can they know if that provider really knows what they're talking about when it comes to hormone replacement therapy or whether they're just making up crap because they're the doctor and they think they're supposed to know things. 

Taylor Hahn 27:03 

Yeah. I would say part of it is, and I think nowadays we're seeing more providers who are at least being a little bit more honest. And when patients do come with stuff, anything from social media or, you know, recommendations that they've seen online, at least some providers will say, you know, I'm not an expert in that. I think you need to see someone else. So that would be the first. If your provider actually says that, I mean, I actually think that's a great first step because you don't want to be wasting your time having that conversation with somebody who does not understand how to deal, right? Powered by Notta.ai

Taylor Hahn 27:44 

The second is really asking open-ended questions. How do you feel about hormone therapy? I'm having all of these symptoms. Do you think that it could be perimenopause or menopause? If they immediately respond with, um, no, you're too young for that or, uh, no, this can't be it. And also that's just a natural part of aging. Um, those two things, I feel like are like trigger comments, um, to where you can, you can pretty safely say, okay, I think I know your, your stance on hormone therapy and just treatment of, of some of the symptoms and menopause in general. Um, but I really recommend for patients to come up with a list of questions. Um, that could be, that could be anything. Like you could say, okay, do, uh, do you think that my, um, uh, my skin changes could potentially be related to menopause? Do you think, you know, so like listing out your symptoms is a really helpful first step and then, um, asking additional questions like, you know, what does, um, what does the process of treatment look like? Um, are there labs that I need to have done? Um, that could give you more information. Um, I think it's sometimes surprising for patients that I, uh, when I do an initial evaluation, I order a full panel of testing that they might get from like their primary care. Um, because again, menopause is whole health. It is affecting your entire body. Um, you know, something we, um, didn't talk about, but one of the biggest things that I see for patients, um, that can be really surprising in menopause is, um, they will have newly elevated cholesterol or, um, new prediabetes or diabetes in menopause that they never had issues with before. Um, and that can be devastating because, you know, you think you're overall healthy, you're doing all the right things, but just those effects can, um, can be, um, something that hits you, uh, like a ton of bricks whenever you're, um, you've never experienced that before. Um, so I think some patients are surprised when I do, when I say, "Hey, we're going to get all of these labs, um, and interpret them in a way that can, we can figure out what's going to be the best treatment regimen for you." Um, so if, uh, if somebody says, no, I don't need any labs, uh, to, to do anything for you, um, that might be a red flag, um, because I think that, uh, that's a huge component of menopause treatment. 

Tanya Hale 30:21 

Okay. That's good to know. Yeah. Okay. One last question. How long, so I'm doing some HRT right now. So how long do I do that? I mean, do I do it until the day I die or do I hit a point where it becomes unnecessary as, as my body gets older? I don't, I just don't know the answer to that question. 

Taylor Hahn 30:44 

That's a really great question, and one that I get very frequently. I would say the prior mentality was lowest amount of hormone therapy or lowest dose for the shortest amount of time. And so as providers, we would take that and say, well, I think you only need to be on it for a year or a couple of years. Now we know, and there are actually good studies that have looked at this, that length of hormone therapy actually can continue to provide you a lot of benefits overall. Heart health is one of my biggest points that I talk to patients about because I mean, it's the number one killer of women, right? It's not breast cancer, it's heart disease. And so making sure that women understand that that is a huge component of treating menopause for multiple years across their lifespan, right? 

Taylor Hahn 31:47 

So the short answer is that there's really no limit to how long you can use it. Now, if some patients want to say, hey, I'd like to kind of evaluate every year or every couple of years and see if I do want to decrease in dose, or if I do want to trial off of it, a lot of patients may get some breakthrough symptoms when they do that. And so that kind of helps to prove to them like, okay, yes, this is helping me significantly. And really just for long term and longevity, it can be really helpful. So no limit, but I do have patients who really want to reevaluate consistently. 

Tanya Hale 32:31 

Yeah. And I guess it would depend on, you know, I look at me with my with my menopause and the only big symptom that I've had has been like my libido just went crazy. So I mean, went crazy as far as like tanked, right? Like, like nothing. And, and which, you know, I can work my mind around that I can, I can still step into, you know, having a good sexual response because I choose to go there in my brain. I'm not waiting for my body to tell me that I want to have sex. I let my brain tell my body that I want to have sex, which helps. But and I did get on some testosterone at one point, and it seemed to give me a bump for two or three months, and then it's just kind of waned off. So what's up with that? 

Taylor Hahn 33:20 

Yeah. So I think that's a really good point to make is that testosterone we know is a really important component to libido at all ages, but especially as women are aging and going through perimenopause and menopause.We, I think, have traditionally thought of testosterone as the male hormone and estrogen as the female hormone. And why would you need  testosterone as a woman unless you were, you know, trying to transition in some way. So testosterone, actually all human bodies actually have more testosterone in their bodies than estrogen and progesterone. And so making that distinction can be kind of eyeopening for some women because they say, okay, then I'm, I'm totally open to, to trying that. It's something that we do usually monitor a little bit more closely because there is kind of a fine line between side effects and symptoms of testosterone versus how it's going to make you feel or improve. But we know that it can help with libido pretty significantly. Sometimes that is trying to get you to the right level, but then that level may change, especially, you know, we talk about ovarian decline over time. Sometimes you may actually need a little bit of a bump at some point, one point or another, because what was working for you before is maybe not necessarily working for you now. 

Taylor Hahn 34:48 

So that's a really great point that libido, I think is, it's a little bit of an enigma, because there's so many components that fall into place with that. We talk a lot, especially in the sexual health world about responsive desire versus spontaneous desire. And I think that's, that can be really eyeopening for women as well to talk about how, especially if you're in a monogamous relationship, or a long term partnership or marriage, responsive desire tends to become the dominant type of desire. And that that's okay. That is that doesn't make you abnormal. That doesn't mean that there's something wrong with you. It just is how our body chemistry changes whenever we've been in that long term intimate relationship. So just kind of reiterating that there are a lot of changes that happen, but we can absolutely navigate those together. 

Tanya Hale 35:54 

Yeah. Okay. This has been such a great discussion. I've learned some, some great things. And I think it's probably been really helpful for a lot of women too, who don't have somebody there to answer all their questions, you know, and, and to help them. So thank you so much, Taylor. Thank you. Thank you for coming. 

Tanya Hale 36:11 

So really, really quick, any last thoughts? Where, I know that you're based here in Indiana, so everybody's not going to be able to come visit you in your office. Right. Where, where do women go on a national basis? Like to find information, to find someone who's a menopause specialist, to where, where does all that information come from? How do we find a, not just a family practice doctor who has good intentions, but somebody who really knows what they're doing here. 

Taylor Hahn 36:38 

Yeah. Yeah. So as like you mentioned, I'm here in Indiana. I have my own practice called BIA Women's Health Collective and the North side of Indianapolis. So I would love to see patients there. And the nice thing about now, I think, like post-COVID is telehealth is a really great option as well. But you can actually visit the menopause society website. And they have a clinician database that you can find a menopause society certified menopause specialist that's near you within your state may even offer telehealth options. So especially if you're bound a little bit more by transportation issues geographically. And then patients can also find specialists through the International Society for the Study of Women's Sexual Health or ISWISH. That's also a really great resource for clinicians. 

Taylor Hahn 37:56 

Thanks so much for having me on. 

Tanya Hale 37:59 

Oh gosh, thank you for coming on. So I would love to do a follow-up. So I'm going to ask people who listen to sending questions and come back and have you answer some specific questions if you don't mind. I think that'd be really fun in the future. 

Taylor Hahn 38:10 

I would love that. 

Tanya Hale 38:12 

A right, Taylor. So, so great. Thank you so much. 

Taylor Hahn 38:15 

Thank you. Thank you so much for having me. 

Taylor Hahn 38:19 

Thank you so much for joining me today. If you would love to receive some weekend motivation, be sure to sign up for my free "weekend win" Friday email: a short and quick message to help you have a better weekend and position yourself for a  more productive week. Go to tanyahale.com to sign up and learn more about life coaching and how it can help you get to your best self ever. See ya.